By Dr. Shawna Darou, ND
Iron deficiency may seem like a very simple topic to write about, but it something that causes more than a little fatigue, and is extremely common in women, especially women in their 40’s when periods start to get heavy (and also most teenagers!).
Symptoms of iron deficiency include the following:
- Feeling cold
- Hair loss
- Shortness of breath
- Dizziness / lightheadedness
- Brittle nails
- Irregular or fast heartbeat
Ones that I see commonly are dizziness, trouble sleeping, hair loss and especially anxiety. Your nervous system is tremendously effected when a nutrient as important as iron is deficient.
The most common cause of iron deficiency in women is heavy menstruation. If you have heavy periods, it is highly likely that your iron is low. It is almost impossible to keep up with your iron requirements from food alone if your menstrual cycle is heavy.
Given that most women’s periods get heavier after age 35, and continue to get even heavier after age 45, this is a hugely significant issue.
Testing for iron deficiency:
The most common tests for iron deficiency are ferritin and hemoglobin. Ferritin is an indicator or iron stores, and hemoglobin will tell if there is actual anemia from the iron deficiency.
Important note about the numbers: you are aiming for a ferritin at a minimum of 40 ug/L. It is interesting that most labs don’t flag ferritin as low unless it is under 10 or 12. At these levels you would definitely be experiencing symptoms, so please ask for your actual levels if you have had your iron tested recently.
Occasionally ferritin levels are high when iron is not too high. This can be from inflammation, and also metabolic syndrome. If high ferritin does not make sense next to hemoglobin, a separate iron panel is recommended to check more thoroughly.
Bringing up iron levels
In some cases, a good focus on nutrition can bring up iron levels, emphasizing lots of dark leafy greens and including red meat and liver. If however your periods are very heavy, this will not likely be enough. In this brief article, I can’t make specific recommendations with iron dosages, because it depends on how low your level is, and your overall digestive system. As you probably know, many iron supplements can be constipating, however we can usually find ones that are well tolerated if this has prevented you from taking iron supplements in the past.
Iron absorption issues
A brief note here about iron absorption: in some cases there are issues with iron absorption that usually have to do with upper GI concerns such as H. pylori infection SIBO, celiac disease or low stomach acid. If your levels are not going up with adequate nutrition changes and supplements, it is important to investigate why.
As with any supplementation, please remember to check your levels periodically to ensure that you are 1) absorbing the supplement well and levels are improving; and 2) that you still need the supplement once levels are restored. Too much iron is not a good thing either!
If you have heavy periods, are in your 40’s and have not had your iron level checked recently, please ask at your next appointment! Remember that low iron can cause a whole constellation of symptoms ranging from anxiety and sleep disruption to hair loss and fatigue. It’s an important factor to address well.